SCIENTIFIC FRAUD

What do doctors rely on? What do medical schools rely on? What do medical journals rely on? What do mainstream medical reporters rely on? What do drug companies rely on? What does the FDA rely on?

They all rely on the sanctity of published clinical trials. These trials determine whether drugs are safe and effective and if medical procedures work. The tests are done on human volunteers. The results are tabulated. The trial is described in a paper that is printed by a peer reviewed medical journal.

This is science. This is rationality. This is the solid foundation upon which all is built. Without these studies, the whole field of medical research would fall apart in utter chaos.

It’s upon this foundation, and through media, that the public becomes aware of the latest breakthrough, the newest medicine. Through doctors in their offices, the public finds out what drugs they should take—and their doctors know because they have read the published reports in the medical journals, the reports that describe the clinical trials. Or, if the doctors haven’t actually read the reports, they’ve been told about them.

When mainstream advocates attack so-called alternative or natural health, they tend to mention that their own profession is based on a solid foundation with pillars of “real science”, on “clinical trials”, is “evidenced based” and most importantly “peer reviewed”.

It all goes back to this solid foundation upon which all trust and faith in modern medicine is built.

The act of publishing a scientific finding is an essential part of the practice of science itself. You want a job? Tenure? A promotion? A juicy grant? You need to have a list of peer-reviewed publications, because publications are the coin of the scientific realm. You can either publish or perish. Being a published researcher is what provides legitimacy and credibility. The main question being asked of many a candidate for hiring or promotion is “how many articles?”

BUT,

What if this “solid foundation” wasn’t quite what you thought it was?
What if a lot of what gets published in peer reviewed medical journals was just fake?

Evidence suggests that up to 90 percent of landmark cancer research may be false

Nature 483, 531–533; 2012, Raise standards for preclinical cancer research. Researchers C. Glenn Begley and Lee Ellis found that only 11 percent of the papers on cancer they studied published in reputable, peer-reviewed journals were solid, while the other 89 percent could not be reproduced, implying that they may be false, or at the very least extremely misleading.“The scientific community assumes that the claims in a preclinical study can be taken at face value – that although there might be some errors in detail, the main message of the paper can be relied on and the data will, for the most part, stand the test of time,” wrote the authors about their findings. “Unfortunately, this is not always the case…Sadly, clinical trials in oncology have the highest failure rate compared with other therapeutic areas…Many landmark findings in preclinical oncology research are not reproducible…”Based on a review of 53 published papers on cancer, Begley and Ellis discovered that only six of them could be reproduced and confirmed in a clinical setting. And the worst part was that the 53 papers were considered to be “landmark,” which means they are generally recognized as having had a significant impact on cancer research due to presenting some new cancer treatment approach or novel therapy for targeting cancer cells. The problem is so big, in fact, it inspired a publication called the Journal of Irreproducible Results.Documentation

Nature Reviews Drug Discovery,10, 712 (September 2011) Believe it or not: how much can we rely on published data on potential drug targets? By: Florian Prinz, Thomas Schlange & Khusru Asadullah Only about 25% of published preclinical studies could be validated to the point at which projects could continue.“at least 50% of published studies, even those in top-tier academic journals, can’t be repeated with the same conclusions by an industrial lab.”Documentation

PLoS Medicine, August 2005 | Volume 2 | Issue 8 | e124 Why Most Published Research Findings Are False By: Stanford University professor Dr. John Ioannidis, M.D.“It can be proven that most claimed research findings are false.”Documentation

Journal of the American Medical Association, 2005;294(2):218-228 Contradicted and Initially Stronger Effects in Highly Cited Clinical Research By: Stanford University professor Dr. John Ioannidis, M.D.“As much as 30 percent of the most influential original medical research papers later turn out to be wrong or exaggerated.”Documentation

British Medical Journal, 1991 Oct 5;303(6806):798-9
Where is the wisdom…? The poverty of medical evidence
By: Dr. Richard Smith, former editor of the British Medical Journal and chief executive of the BMJ publishing Group for 13 years.“Only about 15% of medical interventions are supported by solid evidence…This is partly because only 1% of the articles in medical journals are scientifically sound, and partly because many treatments have never been assessed at all.Documentation

Nature (2006)| doi: 10. 1038/nature 05032
Quality and value: The true purpose of peer review
By: Dr. Charles G. Jennings, executive editor of the Nature Research Journals“scientists understand that peer review per se provides only a minimal assurance of quality, and that the public conception of peer review as a stamp of authentication is far from the truth.”Documentation

Breast Cancer Research, 2010, 12(Suppl 4):S13
Classical peer review: an empty gun
By: Dr. Richard Smith, former editor of the British Medical Journal and chief executive of the BMJ publishing Group for 13 years.“If peer review was a drug it would never be allowed onto the market, says Drummond Rennie, deputy editor of the Journal of the American Medical Association, and intellectual father of the international congresses of peer review that have been held every four years since 1989. Peer review would not get onto the market because we have no convincing evidence of its benefits but a lot of evidence of its flaws.”Documentation

Canadian Urological Association Journal, 2012; 6(1):11
By: D. Robert Siemens, CUAJ Associate Editor“If peer review were a medicine, it would never get a licence…We had great difficulty in finding any real hard evidence of the system’s effectiveness.”Documentation

The New York Times, 2006, For Science’s Gatekeepers, a Credibility Gap.“If peer review were a drug, it would never be marketed…”
Readers of the New York Times got a dose of reality in this 2006 article when Dr. Lawrence Altman, M.D., the paper’s senior medical reporter, wrote a scathing appraisal of science journal editors’ poor performance in maintaining scientific integrity. Dr. Altman cleared the smoke and mirrors to reveal that the scientific fraternity has vested financial and political interests in maintaining the illusion that “passing peer review is the scientific equivalent of the Good Housekeeping seal of approval.”Documentation

United States Supreme Court DAUBERT v. MERRELL DOW PHARMACEUTICALS, INC., (1993), No. 92-102“The fact of publication (or lack thereof) in a peer reviewed journal thus will be a relevant, though not *dispositive, consideration in assessing the scientific validity of a particular technique or methodology on which an opinion is premised.” *
dis·pos·i·tive- adjective: \di-ˈspä-zə-tiv\: directed toward or effecting disposition (as of a case) <dispositive evidence>Documentation

“…most of what appears in peer-reviewed journals is scientifically weak…”

Journal of Participatory Medicine, 2009(Oct);1(1):e13. In search of an optimal peer review system.
By: Dr. Richard Smith, former editor of the British Medical Journal and chief executive of the BMJ publishing Group for 13 years.“After 30 years of practicing peer review and 15 years of studying it experimentally, I’m unconvinced of its value… most of what appears in peer-reviewed journals is scientifically weak…It does, however, feel very bold for editors to abandon prepublication of peer review—like walking into the street naked. But if the emperor has no clothes, what’s to be lost? Nothing, but much is to be gained.Documentation

Dr. Marcia Angell, M.D., Harvard Medical School, former editor-in-chief of the New England Journal of Medicine sees the current situation clearly. In her 2009 article “Drug Companies & Doctors: A Story of Corruption”, published in The New York Review of Books magazine, Angell wrote:“Similar conflicts of interest and biases exist in virtually every field of medicine, particularly those that rely heavily on drugs or devices. It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.”Documentation

Journal of The American Medical Association JAMA Internal Medicine, 2013;173(11):972-979
Characteristics of Oncology Clinical Trials: Insights From a Systematic Analysis of ClinicalTrials.gov
By: Hirsch et al.
This extensive study compared 8942 oncology clinical trials conducted between 2007 and 2010 with trials for other diseases. Trials for cancer drugs were 2.8 times more likely not to be randomised, 2.6 times more likely not to use a comparator (single arm), and 1.8 times more likely not to be blinded. Each undermines the validity of outcomes but reflects what regulators will allow. “There are significant variations between clinical trials in oncology and other diseases…The rate of negative results that go unpublished further complicates analytic efforts.”Documentation

In other words, most cancer trials are rigged to look good.

The Permanente Journal,Winter 2007; Volume 11 No. 1, page 86
Overdosed America, The Broken Promise of American Medicine by John Abramson, MD
Review by Howard I Kushner, PhD“Rigging medical studies, misrepresenting research results published in even the most influential medical journals, and withholding the findings of whole studies that don’t come out in a sponsor’s favor have all become the accepted norm in commercially sponsored medical research.”Documentation

United States of America ex rel. Westlock v. Pfizer, Inc., et al (2008 August 1) Civil Action 1:08-CV-11318-DPW
61. “Today, two-thirds to three quarters of trials published in the four most respected medical journals are commercially funded. Several editors of preeminent medical journals have gone so far as to say that their publications have devolved into information-laundering operations for the pharmaceutical industry.”Documentation

What matters is not whether a scientific idea or article has been peer-reviewed but whether the science described is right, i.e. accords with empirical evidence.

Journal of the American Medical Association,1997;277:1224-1228.Withholding research results in academic life science. By: Blumenthal D, et al.
Delay of Publication Study of 2,157 life science faculty in the top 50 NIH-funded Universities.
19.8% of respondents delayed publication of articles for more than 6 mos to serve proprietary needs:

to allow for patent application or negotiation

to protect scientific lead

to slow the dissemination of undesired results

to resolve intellectual property ownership disputes

8.9% reported refusing to share research results with other university scientists in the last 3 years.

A significant number of cancer deaths during trials are “mistakenly” reported…

Journal of the National Cancer Institute, 1993; Vol. 85, No. 12: p 979-987
Noncancer deaths in white adult cancer patients. By: Brown, Barry W et al.“Because more noncancer deaths occurred shortly after diagnosis, it appears that this excess was caused by treatment of the cancer.”
An analysis of records from 1.2 million cancer patients showed that non-cancer deaths constituted 21% of all deaths and were 37% higher than expected, and most occurred shortly after diagnosis. The authors attributed it to treatment. This excess in deaths from other causes ranged from 9% for breast and colon cancer to 173% for lung cancer. Major causes of these excess deaths were listed as heart and respiratory failure, the types of death expected from radiotherapy and chemotherapy.Documentation

If a stage 4 lung cancer patient dies during treatment, the oncologist can simply say they died of respiratory failure and they will not be counted as a statistic of death from cancer!

Journal of the National Cancer Institute, 2002; Feb Vol. 94, No. 3: p 167-73
All-cause mortality in randomized trials of cancer screening. By: William C. Black, David A. Haggstrom & H. Gilbert Welch.“Conclusion: Major inconsistencies were identified in disease-specific and all-cause mortality end points in randomized cancer screening trials. Because all-cause mortality is not affected by bias in classifying the cause of death, it should be examined when interpreting the results of randomized cancer screening trials…a reduction in disease-specific mortality should not be cited as strong evidence of efficacy when the all-cause mortality is the same or higher in the screened group.”Documentation

“cancer death rates are systematically underestimated…”

Journal of the National Cancer Institute, 2002; July Vol. 94, No. 14: p 1044-1045
Attribution of Deaths Following Cancer Treatment. By: Colin B. Begg & Deborah Schrag“the National Cancer Institute continues to report death rates using deaths for which cancer is designated as the sole underlying cause…cancer death rates are systematically underestimated, in that many patients who die as a result of cancer treatment do not have cancer recorded as the underlying cause of death.”

Journal of Law, Medicine and Ethics, 2013, Vol. 14, No. 3: 590-610
Institutional Corruption of Pharmaceuticals and the Myth of Safe and Effective Drugs. By: Donald W. Light, Ph.D., Joel Lexchin, M.Sc., M.D., Jonathan J. Darrow, J.D., M.B.A., LL.M., S.J.D.“Industry-friendly rules allow companies to exclude those patients most likely to have adverse reactions, while including those most likely to benefit, so that drugs look safer and more effective than they are in practice…Most new drugs approved and promoted since the 1970s lack additional clinical advantages over existing drugs and — as with all drugs — they have been accompanied by harmful side effects.”Documentation

The facts show that a considerable amount of published scientific research is questionable at best due to influence from the pharmaceutical industry. A University of Michigan study that looked at research funding found that at least 29 percent of published research papers were conducted with serious conflicts of interest, which more often than not stemmed from drug industry funding that steered the research in a pre-determined direction.“Given the frequency we observed for conflicts of interest and the fact that conflicts were associated with study outcomes, I would suggest that merely disclosing conflicts is probably not enough,” says Dr. Reshma Jagsi, M.D.“It’s becoming increasingly clear that we need to look more at how we can disentangle cancer research from industry ties.”
The analysis, which itself was published in the American Cancer Society journal CANCER, stated that conflicts of interest cause some researchers to report positive results for Pharmaceutical companies, rather than what is actually occuring.U of M Report– “29 percent of cancer studies report conflict of interest”
Cancer, 15 June 2009, Volume 115, Issue 12, pages 2783–2791.
Frequency, Nature, Effects, and Correlates of Conflicts of Interest in Published Clinical Cancer Research
By: Reshma Jagsi, MD, DPhil1; Nathan Sheets, BS2; Aleksandra Jankovic, MS3; Amy R. Motomura, BSE1;
Sudha Amarnath, BS2; and Peter A. Ubel, MD3,4Documentation

Deutsches Ärzteblatt International2010; 107(16): 279–85
The Financing of Drug Trials by Pharmaceutical Companies and Its Consequences
By: Schott et al“Published drug trials that are financed by pharmaceutical companies may present a distorted picture…there was evidence that pharmaceutical companies influenced study protocols in a way that was favorable to themselves.”Documentation

Annals of Oncology 00: 1–6, 2013
Bias in reporting of end points of efficacy and toxicity in randomized, clinical trials for women with breast cancer, By: Tannock et al“Of 164 included trials, 33% showed bias in reporting of the PE (primary end point) and 67% in the reporting of toxicity.”Documentation

Dr. Marcia Angell, M.D., Harvard Medical School, former editor-in-chief of the New England Journal of Medicine addresses this in her 2009 article “Drug Companies & Doctors: A Story of Corruption”, published in The New York Review of Books magazine, Angell wrote: “it is not surprising that industry-sponsored trials published in medical journals consistently favor sponsors’ drugs—largely because negative results are not published, positive results are repeatedly published in slightly different forms, and a positive spin is put on even negative results. A review of seventy-four clinical trials of antidepressants, for example, found that thirty-seven of thirty-eight positive studies were published.19 But of the thirty-six negative studies, thirty-three were either not published or published in a form that conveyed a positive outcome. It is not unusual for a published paper to shift the focus from the drug’s intended effect to a secondary effect that seems more favorable.”Documentation

House of Commons Health Committee
National Institute for Health and Clinical Excellence
Eighth Report of Session 2012–13
In a report published on January 8, 2013, the committee announced that the deliberate burial of results from clinical trials in order to skew opinion on new pharmaceutical drugs, should neither be ‘legal or considered ethical’.According to the committee, chaired by Member of Parliament and Chair of the Committee Stephen Dorrell, “there should be both a professional and legal obligation to ensure that all regulators… have access to all the available research data about the efficacy and safety of pharmaceutical products… including negative information.” It was also recommended that that this information should be publicly available.Documentation

Alliance for Human Research Protection, November 13, 2010
Medical Journals Complicit in Corruption of Medicine. By: Vera Hassner Sharav“…we observed that not only the pharmaceutical industry, but physician-scientists, academic institutions, and medical journals are all invested in “keeping up appearances” rather than preserving the integrity of science, and honest medicine…”Documentation

Journal of the American Medical Association, 1999; 282 (15):1453-1457
Evaluation of Conflict of Interest in Economic Analyses of New Drugs Used in Oncology
By: Frieberg et al. Industry sponsored studies of cancer drugs reached unfavorable conclusions much less often than studies with nonprofit funding (5% vs 38%).“Recent studies have found that when investigators have financial relationships with pharmaceutical or product manufacturers, they are less likely to criticize the safety or efficacy of these agents… Studies funded by pharmaceutical companies were nearly 8 times less likely to reach unfavorable qualitative conclusions than nonprofit funded studies…”Documentation

Accountabilty in Research, 2009; 16(2): 78–105
Prevalence of Industry Support and its Relationship to Research Integrity. By: Tereskerz et al. This random sampling of 1,100 Medical clinicians in 33 American Universities demonstrated the following;

66% receive financial support from Pharmaceutical companies.

7% own equity in a Pharmaceutical company supporting their research.

8% revealed that a sponsor asked them to publish favorable results for the sponsor’s product.

7% were asked to keep their research results secret.

54% had first hand knowledge of compromised research due to industry support.

Accountabilty in Research, 2009; 16(2): 75-77
Editorial By: Dr. Sheldon Krimsky, Ph.D.“investigators with industrial support are at least twice as likely to engage in trade secrecy or to withold research results from colleagues as are investigators without such support.”Documentation

Arthritis Research & Therapy, 2004, Vol 6 No 3; r250-r255
Equipoise, design bias, and randomized controlled trials: the elusive ethics of new drug development.
By:Fries and Krishnan. Results: This study found that every single trial they reviewed (45 out of 45) favored the drug of the study sponsor…Clearly, the results of these trials could have been accurately predicted based on knowledge of sponsorship alone.Documentation

The New England Journal of Medicine,2008; 358:252-260
Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy
By: Turner et al. This paper showed that among 74 FDA registered studies of antidepressants, there were 38 studies that produced positive results and 37 of them were published. Of the 36 remaining negative studies, 22 were not published, 11 were published falsely conveying a positive outcome, and 3 were published as negative.This means that if one were to read the published literature, one would believe that 94% of the trials conducted were positive. In contrast, the study authors, who reviewed all the FDA studies, found only a 51% rate of positive trials.Documentation

New York Magazine, What’s Up, Docs? A panel of anonymous physicians coughs up secrets of the trade. By Robert Kolker Published Jun 10, 2007
Question: “What is the worst ethical lapse you’ve seen?”
Dr. Lung: “Research is a real problem. Doctors just make up the data. They don’t report negative side effects, no question about it. I used to write the results on my reports that were negative and nobody printed them. Only if it’s positive does it get published in a journal. A doctor I know used to publish papers like nobody’s business, and all the doctors who came and left told me he made up data to satisfy NIH grants and pharmaceutical grants. He was and still is very popular.”Documentation

Royal Society (2006) Science and the Public Interest- Communicating the Results of New Research to the Public, London: Royal Society“Some current ‘normal’ practices within the research community are not consistent with public interest. One example is the tendency not to communicate results that are negative…”Documentation

“96% of the researchers funded by industry found that their sponsor’s products were safe…”

Canadian Dimension, Volume 44, Number 1: January/February 2010
Whose Bread You Eat, His Song You Sing: Why Doctors and Researchers Should Take a Pass on Drug Industry Money. By: Professor Arthur Schafer, University of Manitoba.“It may be worth spelling out just how influential drug company sponsorship appears to have been: 96% of the researchers funded by industry found that their sponsor’s products were safe; when research funding was industry independent the rate of positive findings dropped to 37%. That’s some difference. One is irresistibly drawn to that old proverb: Whose bread you eat, his song you sing.”Documentation

Canadian Medical Association Journal, 2001 Sep 18; 165(6): 786–788.
Sponsorship, authorship and accountability, By: Davidoff et al.“Many clinical trials are performed to facilitate regulatory approval of a device or drug rather than to test a specific novel scientific hypothesis…even when an investigator has had substantial input into trial design and data interpretation, the results of the finished trial may be buried rather than published if they are unfavourable to the sponsor’s product. Such issues are not theoretical. There have been a number of recent public examples of such problems, and we suspect that many more go unreported.”Documentation5. Kahn JO, Weng D, Mayer K, Murray H, Lagakos S, for the 806 Investigator Team. Evaluation of HIV-1 Immunogen, an Immunologic Modifier, Administered to Patients Infected With HIV Having 300 to 549 × 106/L CD4 Cell Counts JAMA 2000;284:2193-202.
6. Blumenthal D, Campbell EG, Anderson MS, Causino N, Louis KS. Withholding research results in academic life science: evidence from a national

British Medical Journal, 2003; 326: 1167–70
Pharmaceutical industry sponsorship and research outcome and quality: systematic review
By: Lexchin et al.“Clinical research sponsored by the pharmaceutical industry affects how doctors practise medicine. A recent systematic review…of biomedical research found that studies financed by industry…always found outcomes favourable to the sponsoring company.”Documentation

Deutsches Ärzteblatt International, 2010; 107(17): 295–301
The Financing of Drug Trials by Pharmaceutical Companies and Its Consequences. By: Schott et al.“This systematic review clearly shows that clinical trials with the involvement of pharmaceutical companies often present the therapeutic benefit of a drug in too positive a light and also fail to mention risks…A large number of physicians are involved in the planning and conduct of drug trials. For the benefit of their patients, they should assume greater responsibility and work to counteract the economic self-interest of pharmaceutical companies in research and clinical practice.”Documentation

“two major trials he had published were fraudulent…”

Journal Of The Royal Society Of Medicine, 2006; 99:115–119. The trouble with medical journals,
By: Dr. Richard Smith, former editor of the British Medical Journal and chief executive of the BMJ publishing Group for 13 years.“…medical journals often contain poor science…In one phone call in December 2002 I had to tell the editor of the Lancet that I had compelling evidence that two major trials he had published were fraudulent…studies that find a treatment, often a drug, to be effective tend to be published more than once, whereas those studies that find that the treatment does not work are often not published at all. The result is a systematic bias in medical information that makes some treatments seem much more effective than they actually are. Patients are then mistreated… I’m concerned that much of what journals do is ethically weak.”Documentation

The New Yorker, December 13, 2010, The Truth Wears Off, By Jonah Lehrer.This article demonstrates how Pharmaceutical interests are encouraging bogus studies.
The whole idea of science is that once you’ve established a truth, it stays put: you don’t combine hydrogen and oxygen in a particular way and sometimes you get water, and other times chocolate cake. Reliable findings are how we’re able to shoot a rocket and have it land on the moon, or step on the gas and make a car move (predictably), or flick a switch and turn on the lights. Things that were true yesterday don’t just become untrue. Right??“Many results that are rigorously proved and accepted start shrinking in later studies.” The problem is that anything can happen once, at random. That’s why it’s important that a result be replicable (repeatable by another scientist): like that light switch, if someone else tries it, you better get the same result. But the article points out that most published results are never replicated by another researcher. All sorts of well-established, multiple confirmed findings have started to look increasingly uncertain. It’s as if our facts were losing their truth: claims that have been enshrined in textbooks are suddenly unprovable… “…even after a claim has been systematically disproven…you still see some stubborn researchers citing the first few studies that show a strong effect. They really want to believe that it’s true.” – Dr. John Ioannidis, M.D.Documentation

A service from The British Medical Journal, called bmjupdates+ vets new studies for clinicians, and finds that typically only 3,000 of 50,000 new journal articles published each year are well-designed, relevant enough and have adequate methods to support their conclusions for key aspects of clinical care. That’s 6 percent.Documentation

PLoS ONE 4(5): e5738, (2009)
How Many Scientists Fabricate and Falsify Research? A Systematic Review and Meta-Analysis of Survey Data, By: Daniele Fanelli“A popular view propagated by the media and by many scientists sees fraudsters as just a ‘‘few bad apples’’…Increasing evidence, however, suggests that known frauds are just the ‘‘tip of the iceberg’’, and that many cases are never discovered…[In this study]1.97% of scientists admitted to have fabricated, falsified or modified data or results at least once –a serious form of misconduct by any standard– and up to 33.7% admitted other questionable research practices. In surveys asking about the behaviour of colleagues, admission rates were 14.12% for falsification, and up to 72% for other questionable research practices.”Documentation

“Drug company experts advised staff to withhold data…”

Canadian Medical Association Journal, 2004 Mar 2;170(5):page 783
Drug company experts advised staff to withhold data about SSRI use in children
By: Kondro and Sibbald“An internal document advised staff at the international drug giant GlaxoSmithKline (GSK) to withhold clinical trial findings in 1998 that indicated the antide-pressant paroxetine (Paxil in North America and Seroxat in the UK) had no beneficial effect in treating adolescents…Sales for Seroxat amounted to almost $4.97 billion worldwide in 2003. Study 329, conducted in the US from 1993–1996, was the largest trial to date on using an SSRI in a pediatric population. According to the document, the results indicated paroxetine was no more effective than placebo. In the other trial, Study 377, carried out in Europe, South America and elsewhere, placebo was actually more effective than the antidepressant.”Documentation

The secret internal GlaxoSmithKline documents state the following: “TARGET To effectively manage the dissemination of these data in order to minimize any potential negative commercial impact…It would be commercially unacceptable to include a statement that efficacy had not been demonstrated…”Documentation

Fraud has even happened at the most prestigious cancer center in the world!

Research fraud at Memorial Sloan-Kettering Cancer Center in New York rocked the Medical world.
The New York Times called it “a medical Watergate” that reflected “dangerous trends in current efforts to gain scientific acclaim and funds for research.” They were as well cited for “manipulating national attention and attracting an enormous amount of money for the institute.”Documentation

Evidence-based medicine is valuable to the extent that the evidence base is complete and unbiased. Selective publication of clinical trials — and the outcomes within those trials — can lead to unrealistic estimates of drug effectiveness and alter the apparent risk–benefit ratio.

This is why you shouldn’t believe some exciting new medical study!

Researchers writing in the American Journal of Medicine and the Journal of Translational Medicine discovered something that should change how you think about medical news. They looked at 101 studies published in top scientific journals between 1979 and 1983 that claimed a new therapy or medical technology was very promising or a “breakthrough”. Only five, they found out, made it to market within a decade. Only one (ACE inhibitors, a pharmaceutical drug) was still used at the time of their publication in 2003-2004.Documentation

Just one.

But you’d never know that from reading the press!

So why would journals print questionable articles anyway?

MONEY!

One of the biggest income makers for major medical journals, besides ads, is the sale of reprints to drugmakers. Drug reps like to hand out glossy reprints to doctors to create the charade that what they say is based on hard science, and to further create the illusion that the doctor is a careful scientist who will of course take the reprint back home and study it line by line. It’s a much better show if the reprint carries the byline of a highly respected journal.

“Editor earned more than $20m in royalties from device manufacturer”

British Medical Journal, 2010; 340, (Published 26 January 2010) By: Jeanne Lenzer“The Association for Medical Ethics has said that editors should not receive more than $50,000 from a drug or device company.”Documentation

The Nation, January 10, 2002. Rx Needed for Medical Journals, By: Sonia Shah.“Why did the esteemed Journal of the American Medical Association publish a paper showing that blockbuster anti-arthritis drug Celebrex is superior to a $7 bottle of ibuprofen, while the FDA maintains it isn’t? Because the scientists who wrote the paper–their expenses paid by Celebrex manufacturer Pharmacia–selectively omitted half their study data to make the boss’s drug look good.”Documentation

British Medical Journal, 2003;326:1202–5. Medical journals and pharmaceutical companies: uneasy bedfellows, By: Dr. Richard Smith, former editor of the British Medical Journal and chief executive of the BMJ publishing Group for 13 years.
Summary points
1. Free newspapers for doctors depend completely on income from pharmaceutical advertising, but many journals also depend heavily on such advertising
2. The advertising is often misleading
3. Editorial coverage is much more valuable to drug companies than advertising, and scientific studies can be manipulated in many ways to give results favourable to companies 4. Many medical journals have a substantial income from supplements and reprints paid for by drug companies.Documentation

The Lancet, March 1, 2003, Vol 361: 712-713
Commentary by Dr. Richard Horton, M.D., FRCP, FMedSci, present editor-in-chief of The Lancet “Whether owned by a commercial publisher, a society, a trade union, or a prestigious college, journals aim to be profitable.That means editors and publishers alike steer the content of their journals to readerships that will be able to afford subscriptions, advertisers who will want to buy space, and organisations that will want to purchase reprints.”Documentation

PloS Medicine, May 2005, Volume 2, Issue 5: e138Medical Journals Are an Extension of the Marketing Arm of Pharmaceutical Companies,
By: Dr. Richard Smith, former editor of the British Medical Journal and chief executive of the BMJ publishing Group for 13 years.
“…trials rarely produce results that are unfavourable to the companies’ products…a favourable trial is worth thousands of pages of advertising, which is why a company will sometimes spend upwards of a million dollars on reprints of the trial for worldwide distribution.”Documentation

New York Times, May 2, 2006, The Doctor’s World
For Science’s Gatekeepers, a Credibility Gap, By: Lawrence K. Altman, M.D.“A few journals that not long ago measured profits in the tens of thousands of dollars a year now make millions, according to at least three editors who agreed to discuss finances only if granted anonymity, because they were not authorized to speak about finances.”Documentation

British Medical Journal, 2006;332:1444–7
Commercial influence and the content of medical journals, by: Joel Lexchin & Donald W. Light“Articles in medical journals that criticise the drug industry can result in substantial loss of advertising revenue.”Documentation

Massachusetts Medical Society. 2008 annual report. Chapter 58. MMS, 2008:10.The New England Journal of Medicine, confirms the increasing reliance on reprint revenues. Speaking at the 2008 meeting of the Massachusetts Medical Society (which publishes the journal), Jeffrey M. Drazen, MD, Editor-in-Chief, said: “The results in recruitment advertising and bulk reprints were outstanding this year; they went a long way to offset declines in print-based revenue that all publishers are experiencing.”Documentation

PLoS Medicine, October 2010, Volume 7; Issue 10: e1000354
Conflicts of Interest at Journals, by: Lundh et al.“…journals not only stand to gain financially through the sales of reprints, but also publication of such trials may increase their impact factors, as a large number of reprints distributed to key clinicians by drug companies will likely increase citation rates. For example, The New England Journal of Medicine (NEJM) sold about one million reprints to Merck of its paper on the VIGOR trial of rofecoxib.”Documentation

British Medical Journal, 2011; 343: d6448
Should journals sell reprints? No, By: Tom Jefferson“We know that some large journals derive up to 40% of their income from the reprint business…Reprints (especially those bearing the cover of a prestigious journal) are the currency of marketing. How many readers have been approached by drugs sales staff bearing gifts and a copy of the latest paper showing their product to be superior to that of their competitors?”Documentation

British Medical Journal Blog, 2012, July 3. Medical journals: a gaggle of golden geese
By: Dr. Richard Smith, former editor of the British Medical Journal and chief executive of the BMJ publishing Group for 13 years.“The big sales of reprints are almost always to pharmaceutical companies, and the publishers are very active in selling them…I applaud the Lancet and BMJ for providing data on reprints, but the publishers of the New England Journal of Medicine (Massachusetts Medical Society), JAMA (American Medical Association), and the Annals of Internal Medicine (American College of Physicians) all declined. They clearly have something to hide.”Documentation

“If we publish a study that finds positive results, then the industry is delighted and buys lots of reprints…”

Increasingly, published scientific research including cancer studies and trials are found out to be fabricated and fake!

New York Times, May 2, 2006 The Doctor’s World
For Science’s Gatekeepers, a Credibility Gap, By: Lawrence K. Altman, M.D.“Fraud is a substantial problem, and the attitude toward it has changed little over the years, other editors say. Some journals fail to retract known cases of fraud for fear of lawsuits.”Documentation

Example #1Journal of Clinical Oncology, 1995 Oct;13(10):2483-9.
High-dose chemotherapy with hematopoietic rescue as primary treatment for metastatic breast cancer: a randomized trial. By: Bezwoda WR1, Seymour L, Dansey RD. Department of Medicine, University of Witwatersrand, South Africa.This widely referenced trial suggested a striking benefit of high-dose chemotherapy for both lymph node-positive and metastatic breast disease. This study caused a significant number of women to pursue this highly expensive course of treatment since it appeared in many patient protocol handbooks.Documentation

BUT, there was a problem. This study was compiled from evidence that was COMPLETELY FABRICATED!Documentation

In 2001, The Journal of Clinical Oncology retracted the Bezwoda published study.Documentation

At a press conference, ASCO’s outgoing president Lawrence H. Einhorn, M.D., called the study “outright scientific fraud.” ASCO president-elect, now president, Larry Norton, M.D., said there is unequivocal evidence to show that principal author Werner Bezwoda, M.D., Ph.D., of South Africa “really duped us all.”

The Lancet quickly retracted the article. He also “ fundamentally mishandled ” data for a 2001 article in The New England Journal of Medicine, which was retracted.Documentationand a 2005 article in Journal of Clinical Oncology.

The U.S. Department of Health and Human Services found Dr. Sudbø guilty of scientific misconduct. “In addition to three publications for which Dr. Sudbø admitted falsifying and/or fabricating data, the Investigation Commission found at least twelve other publications that warranted retraction because they could not be considered valid.”Documentation

Example #3
In 1994, the story leaked that Dr. Roger Poisson, M.D., a Montreal surgeon, had submitted false information for a landmark study on breast cancer. The findings, published in 1985 and 1989 in the widely respected New England Journal of Medicine, changed medical practice almost immediately. Mastectomy was replaced by lumpectomy in tens of thousands of cases. Hence the shock waves when Poisson’s actions were revealed – he had enrolled 354 of the 2,163 patients in the breast-cancer study and had falsified data on several of them. Furthermore, that deception was part of a larger pattern of fraud: between 1977 and 1990, Poisson apparently faked data in 13 other clinical trials on cancer, all of them part of the National Surgical Adjuvant Breast and Bowel Project (NSABP), which was funded by the U.S. govermnent. In all, investigators found 115 instances of falsified data involving 99 of Poisson’s patients.

The U.S. Department of Health and Human Services found Dr. Poisson guilty of scientific misconduct.Documentation

The New England Journal of Medicine, “FRAUD IN BREAST-CANCER TRIALS”Documentation

The New York Times, “Doctor Says He Falsified Cancer Data to Help Patients”Documentation

Example #4The Journal of Immunology, The expression and functional involvement of laminin-like molecules in non-MHC restricted cytotoxicity by human Leu-19+/CD3- natural killer lymphocytes, November 15, 1988 vol. 141 no. 10, pages 3318-3323. By: Schwarz & Hiserodt. After an investigation, the Univ. of Pittsburgh and the NIH discovered that senior author Dr. John C. Hiserodt, M.D., Ph.D., had fabricated the published data and had further attempted to cover up the misdeed by then fabricating an entire laboratory notebook.

The U.S. Department of Health and Human Services found Dr. Hiserodt guilty of scientific misconduct. “Dr. Hiserodt, a former assistant professor and researcher at the Pittsburgh Cancer Institute, was found to have deliberately falsified critical data and fabricated experimental results in several figures and tables in two grant applications submitted to the National Institutes of Health.”Documentation

The corrections for the fake data were “promptly” printed in The Journal of Immunology on April 15, 2005 after only 16 years or so.Documentation

Example #5
In May of 1981, Dr. John Darsee’s associates and supervisors at Harvard caught him fabricating data. Other investigations led to the conclusion that Darsee fabricated research publications beginning when he was a biology student at Notre Dame, continuing through his medical residency and cardiology fellowship at Emory University, and ending at Harvard. Following the NIH investigation, Harvard retracted 30 of Darsee’s papers and abstracts in February 1983. Review of Darsee’s earlier work at Emory University led to the retraction of an additional 52 papers and abstracts published during his tenure there.

Journal of the American Society for Information Science, “The Persistence of Fraud in the Literature: The Darsee Case”Documentation

Example #6
2012- Dr. Yoshitaka Fujii, M.D., was the subject of an inquiry by the Japanese Society of Anesthesiologists (JSA) who determined that Fujii, who was fired in February from his post at Toho University, falsified data in at least 172 of 212 papers published between 1993 and 2011. He set what is believed to be a record for the number of papers by a single author requiring retractionsDocumentation

Example #7
2005- Paul Kornak, Research Coordinator, VA Medical Center in Albany, NY. Hired in 2000, Mr. Kornak was the Albany site coordinator for several cancer studies. Under his direction, patients who were ineligible because of medical conditions were nevertheless enrolled, since every enrollment resulted in a $5000 payment. Once prosecuted, Kornak pled guilty to making and using a materially false statement (18 U.S.C. § 1001), mail fraud (18 U.S.C. §§ 1341 and 1346), and criminally negligent homicide (New York Penal Law § 125.10 and 18 U.S.C. § 3), and was sentenced principally to be imprisoned for 71 months, as well as directed to pay restitution of $639,000.Documentation

Example #8
2005- Dr. Eric T. Poehlman, Ph.D., Professor, Department of Medicine at the University of Vermont College of Medicine. Dr. Poehlman fabricated more than a decade’s worth of scientific data on obesity, menopause and aging, much of it while conducting clinical research as a tenured faculty member at the University of Vermont. He presented fraudulent data in lectures and in published papers, and he used this data to obtain millions of dollars in federal grants from the National Institutes of Health. On June 28, 2006, Poehlman was ordered to serve a year and a day in federal prison for using falsified data in federal research grants that he submitted for funding. An official with the National Institutes of Health said that this was the first case where an academic research scientist was given prison time for falsifying data in grant submissions.Documentation

Example #9
1978- Dr. Marc Strauss, M.D., Oncologist at Boston University Medical Center. One of Dr. Strauss’ funded projects was with ECOG (Eastern Cooperative Oncology Group) where he led the BUMC effort in that program. Marc Strauss committed fraud by directing his staff, nurses and fellows to falsify data. One narrative states, “The falsifications ranged from [merely] changing a patient’s birth date [to make a patient eligible,] to reporting treatments and laboratory [tests] that were never done and [even] inventing the existence of a tumor in one patient.” The staff was sufficiently concerned that they blew the whistle on Strauss and he was forced to resign in disgrace.Documentation

Example #10
2009- Dr. Scott S. Reuben, M.D., was Professor of Anesthesiology & Pain Medicine at Tufts University in Boston, Massachusetts and chief of acute pain at Baystate Medical Center in Springfield, Massachusetts before being sentenced to prison for healthcare fraud. Reuben was considered a very influential researcher in pain management, and his purported findings altered the way millions of patients are treated for pain during and after orthopedic surgeries. Reuben has now admitted that he never conducted any of the clinical trials on which his conclusions were based in what may be considered the longest-running and widest-ranging cases of academic fraud ever.

Example #11
2010- Dr. Anil Potti, M.D., was a cancer researcher at Duke University who was heralded as a groundbreaking game changer. Dr. Potti’s work, which entailed matching a patient’s tumor to chemotherapy drugs based on its DNA makeup, was the most lauded cancer breakthrough in recent history, according to many involved. Unfortunately, Dr. Potti was found to have manipulated and fabricated research data to support his hypothesis, which led to over 100 terminally ill cancer patients participating in his fraudulent cancer trial. A 2012 60 Minutes segment, revealed that Dr. Potti’s discovery “may end up being one of the biggest medical research frauds ever; one that deceived dying patients, the best medical journals, and a great University.”Duke in facing significant lawsuits currently because they allegedly silenced a whistleblower, frustrated an NCI inquiry, and, in the fall of 2009, set up a biased internal review of the three trials. http://www.cbsnews.com/news/deception-at-duke-fraud-in-cancer-care/Documentation

Example #12
2012- Dr. Dipak Kumar Das, Ph.D., was the director of the Cardiovascular Research Center at the University of Connecticut Health Center in Farmington. On January 11, 2012 the University of Connecticut Health Center announced that a review board found Das guilty of 145 counts of fabrication or falsification of data which appeared in 11 journals. The three-year investigation examined more than seven years of activity in Das’s lab. In May 2012, Das was fired from both positions at the University of Connecticut Health Center, and died the following year. At least twenty of his research papers have been retracted.

“The Respondent engaged in research misconduct by fabricating data that were included in two (2) published papers.”

This includes:

Oncogene February 2009, which found that HIC1, a protein thought to suppress tumor growth, is a “central molecule in a novel mechanism controlling cell growth and that the disruption of this HIC1-mediated pathway may lead to abnormal cell proliferation and, ultimately, cancer.”

Molecular Endocrinology December 2009, which found “reintroducing HIC1 into resistant breast cancer cells restored their sensitivity to the estrogen antagonists, indicating the existence of a novel regulatory mechanism for growth control of breast cancer cells.”

Specifically, six of the eight figures in the Oncogene paper and six of the seven figures in the Molecular Endocrinology study were said to contain data from fabricated experiments. Though Wang is now required to retract the papers, and he reportedly stopped working for Boston University in July, he will only be ineligible for federal funding for 2 years.Documentation

Example #14
2014- Dr. Haruko Obakata, Ph.D., resigned in disgrace from the Japanese RIKEN center for Developmental Biology after it was found that her cellular production process known as Stimulus-Triggered Acquisition of Pluripotency was a fraud. As a result of the negative exposure of the “STAP cells scandal”, on August 5, 2014, Obokata’s mentor and co-author Dr. Yoshiki Sasai committed suicide. A subsequent investigation cleared him of misconduct but criticized him for inadequate supervision of Haruko Obokata, the lead author of the paper. http://www.foxnews.com/health/2014/12/19/disgraced-japan-researcher-fails-to-replicate-game-changing-stem-cell-results/Documentation

Example #15The National Cancer Institutehas even had a paper retracted for faked data. Following an investigation into research misconduct, the Journal of Clinical Investigation has retracted a cancer genetics paper from a laboratory at the National Institutes of Health due to “data falsification and fabrication” The paper, “FOXO3 programs tumor-associated DCs to become tolerogenic in human and murine prostate cancer,” describes an overexpressed gene in mouse prostate cancers that appears to suppress immune system cells. The journal retracted the paper following an investigation into author Dr. Stephanie K. Watkins, then a postdoctoral fellow at the National Cancer Institute.Documentation

Example #16
2011- Marija Manojlovic, University of Pittsburgh former graduate student, Department of Chemistry, UP, engaged in research misconduct in research supported by National Institute of General Medical Sciences (NIGMS), National Institutes of Health (NIH), grant P50 GM067082, National Cancer Institute (NCI), NIH, grant P01 CA078039, National Institute of Mental Health (NIMH), NIH, grant U54 MH074411, and National Institute of Allergy and Infectious Diseases (NIAID), NIH, grant R01 AI033506.nMs.Manojlovic engaged in research misconduct by falsifying and fabricating data.Documentation

Example #17
2012- Dr. Jian Ma, Ph.D., former Research Fellow, Brigham and Women’s Hospital and Harvard Medical School, engaged in research misconduct in research supported by National Cancer Institute (NCI), National Institutes of Health (NIH), grant 5 P01 CA120964, by knowingly and intentionally fabricating and falsifying data.Documentation

Example #18
2012- Dr. Mepur H. Ravindranath, Ph.D., former Director of the Laboratory of Glycoimmunotheraphy, John Wayne Cancer Institute, engaged in research misconduct in research supported by the National Cancer Institute (NCI), National Institutes of Health (NIH), awards R21 CA107316 and R03 CA107831. Dr. Ravindranath engaged in research misconduct by falsifying results reported in two published articles in scientific journals.Documentation

Example #19
2013- Mr. Timothy Sheehy, Frederick National Laboratory for Cancer Research (FNLCR), Frederick, MD, engaged in research misconduct in research supported by National Cancer Institute (NCI), National Institutes of Health (NIH), contract HHSN2612008000001E. ORI found that the Respondent engaged in research misconduct by fabricating and/or falsifying U.S. Public Health Service (PHS)-supported data in Cancer Epidemiol Biomarkers Prev 19(4):973-977, 2010 (hereafter referred to as the “CEBP paper”). Thus, the main conclusions of the CEBP paper are based on fabricated data and are false.Documentation

Example #20
2014- Dr. H. Rosie Xing, Ph.D., University of Chicago, engaged in research misconduct in research supported by National Cancer Institute (NCI), National Institutes of Health (NIH), grant R01 CA098022. Dr. Xing engaged in research misconduct (42 C.F.R. § 93.103-104) by using images that had been among a set of manipulated images produced while at another institution, which had been found to be false by that institution. Dr. Xing then falsely reported these images in Figures 1D, 2A, and Supplementary Figures 1B and 1C in Molecular Cancer Therapeutics 9:2724-36, 2010.Documentation

Example #22
2014- Dr. Makoto Suzuki, M.D., formerly of University of Texas Southwestern Medical Center, and currently a Professor in the Department of Thoracic Surgery, Kumamoto University Hospital, Kumamoto, Japan, engaged in research misconduct in research supported by National Cancer Institute (NCI), National Institutes of Health (NIH), grants P50 CA070907 and U01 CA084971. ORI found that Dr. Suzuki knowingly, intentionally, and recklessly falsified data reported in six (6) publications.Documentation

Example #23
2014- Dr. Takao Takahashi, M.D., Ph.D., formerly of University of Texas Southwestern Medical Center, currently a faculty member in the Department of Surgical Oncology, Gifu University, Graduate School of Medicine, Gifu, Japan, engaged in research misconduct in research supported by National Cancer Institute (NCI), National Institutes of Health (NIH), grant U01 CA084971. ORI found that Dr. Takahashi knowingly, intentionally, and recklessly falsified data reported in four (4) publications.Documentation

Example #24
2015- Dr. Bin Kang, Ph.D., Immunobiology and Cancer Research Program, Oklahoma Medical Research Foundation, engaged in research misconduct in research supported by National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), grants AI056129 and AI104057. engaged in research misconduct by reporting falsified data in multiple journal manuscripts and NCI grant applications.Documentation

Example #25
2015- Dr. Dong Xiao, Ph.D., former Research Assistant Professor, Department of Urology, University of Pittsburgh, engaged in research misconduct in research supported by National Cancer Institute (NCI), National Institutes of Health (NIH), grant R01 CA157477, by reporting falsified data.Documentation

Feb. 21, 2012- Johns Hopkins press release, “Studies Linked To Better Understanding of Cancer Drugs.”DocumentationMay 2012- Dr. Daniel Yuan, M.D., contacts Nature and Johns Hopkins suggesting the study was a sham.
August 8, 2012- On the eve of his deadline for rebuttal to Nature, Dr. Yu-yi Lin was found dead. August 9, 2012- Taipei Times, “Renowned scientist found dead, next to drug bottles”.
March 11, 2013- Washington Post, “Doubts about Johns Hopkins research have gone unanswered, scientist says”. Dr. Daniel Yuan, M.D.,dishes on the faked research happening at Johns Hopkins. March 22, 2013- Washington Post, “At Johns Hopkins, research adheres to highest levels of integrity”, claims Landon S. King, vice dean for research at the Johns Hopkins School of Medicine.
November 6, 2013- Washington Post, “Johns Hopkins scientists retract disputed genetics paper…despite several attempts, we were unable to obtain results definitively supporting the major claims”.
November 7, 2013- Nature, retracts original paper. “All the authors have signed this retraction with the exception of Y.-Y.L., who is deceased.” Nature retraction

Association of College and Research Libraries Conference; Philadelphia, PA..
Retracted publications in biomedicine: cause for concern. 2011. pp. 390–5.
By: Budd J.M, Coble Z.C, Anderson K.M.“The current study found 1,164 retracted articles in the 12-year period between 1997 and 2009. Of the 1,112 articles included for analysis, 55% were retracted for some type of misconduct.”That’s 611 fraudulent articles…Documentation

Journal of Medical Ethics, 2011;37:2 113-117
Retractions in the scientific literature: do authors deliberately commit research fraud?
By: R. Grant Steen. After studying 742 medicine and biology papers that were withdrawn from 2000 to 2010, 26.6% (197 papers) were retracted for fraud.
Conclusions: “This study reports evidence consistent with the ‘deliberate fraud’ hypothesis. The results suggest that papers retracted because of data fabrication or falsification represent a calculated effort to deceive. It is inferred that such behaviour is neither naive, feckless nor inadvertent.”Documentation

The Wall Street Journal, August 10, 2011, Mistakes in Scientific Studies Surge, By: Gautam Naik. Since 2001, while the number of papers published in research journals has risen 44%, the number retracted has leapt more than 15-fold, data compiled for The Wall Street Journal by Thomson Reuters reveal.“At the Mayo Clinic, a decade of cancer research, partly taxpayer-funded, went down the drain when the prestigious Minnesota institution concluded that intriguing data about harnessing the immune system to fight cancer had been fabricated. Seventeen scholarly papers published in nine research journals had to be retracted. A researcher, who protests his innocence, was fired.”Documentation

The Journal of the American Medical Association JAMA, 1990;263(10):1420-1423
The continued use of retracted, invalid scientific literature. By: Mark P. Pfeifer M.D. & Gwendolyn L. Snodgrass, M.S.“An analysis of the literature was performed to determine how often authors had cited 82 fraudulent articles that had already been formally retracted. The 82 invalid articles were cited 733 times by other authors…”Documentation

Surely Wikipedia must be clean and accurate…right?

The Journal of the American Osteopathic Association, May 2014, Vol. 114, 368-373
Wikipedia vs Peer-Reviewed Medical Literature for Information About the 10 Most Costly Medical Conditions. By: Hasty el al. This recent study of Wikipedia entries about medical conditions showed that not only did they contain many errors, but nine out of ten of the articles examined significantly deviated from the best-available scientific evidence.Documentation

Here’s what a Nobel Laureate says about faking research…

“There are scandals in science as there are scandals in politics. But the scandals in science — the uncovering of falsification of scientific findings– are different from those in politics. Like scandals in the banking world, the scandals in science resemble scandals in the religious world: they have a quality of desecration and violate public expectations…I know of at least two cases in which highly respected scientists had to retract findings that had been reported from their laboratories because they discovered that these findings had been manufactured by some collaborator.” from the paper INTEGRITY IN RESEARCH. By: Professor Salvador Luria, M.D., Massachusetts Institute of Technology
1969 Nobel Prize in Physiology for Medicine
1974 National Book Award in Science for his book Life: the Unfinished Experiment
1991 National Medal of ScienceDocumentation

Scientific American, December 17, 2014 Article; For Sale: “Your Name Here” in a Prestigious Science Journal, By: Charles Seife. The article discusses the flood of fake scientific papers coming out of Chinese paper mills. Here is just a small sample they showed of published “fake” research papers.Documentation fake research papers In just one example, the journal Diagnostic Pathology May 2014 issue, Six of the 16 articles contain suspicious repetitions of phrases and other “irregularities”.Documentation

Proceedings of the National Academy of Sciences of the United States of America
January 6, 2015 vol. 112 no. 1, How many scientific papers are not original? By: Michael Lesk. “In some countries, having a paper accepted in a top journal can mean a cash bonus, with Zhejiang University offering a $30,000 payment to an author who publishes in Science or Nature” (1, 2). “Recently I received a request from someone in Asia who wanted to be a postdoctoral researcher in our department in the United States. I took the first two paragraphs of his research statement and found them on a commercial website of a US company…”
1) Davis P (2011) Paying for impact: Does the Chinese model make sense? Available at: scholarlykitchen.sspnet.org/2011/04/07/paying- for-impact-does-the-chinese-model-make-sense/. Accessed November 24, 2014.
2) Shao J, Shen H (2011) The outflow of scientific papers from China: Why is it happening and can it be stemmed? Learn Publ 24(2):95–97.Documentation

Proceedings of the National Academy of Sciences of the United States of America
January 6, 2015 vol. 112 no. 1, Patterns of Text Reuse in a Scientific Corpus
By: Daniel T. Citron and Paul Ginsparg
Roughly 250 submissions per month to *arXiv are currently flagged for “text overlap”. This paper observes a strong cultural connection with plagiarism: there are some countries in which 15% of the submissions to arXiv are plagiarized…*arXiv is a repository of electronic preprints of scientific papers hosted at Cornell University.
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Science, 2013: Vol. 342 no. 6154 pp. 60-65, October 4.
Who’s Afraid of Peer Review?
By: John Bohannon
As part of a sting operation to uncover the realities of peer review, a spoof paper concocted by Science reveals little or no scrutiny at many open-access journals. The author submitted a fake article to more than 300 open access journals, and more than half accepted it. Journals published by Elsevier, Wolters Kluwer, and Sage all accepted the bogus paper.
“The most basic obligation of a scientific journal is to perform peer review”, arXiv founder Dr. Paul Ginsparg, Ph.D., says. He laments that a large proportion of open-access scientific publishers “clearly are not doing that.”Documentation

Proceedings of the National Academy of Sciences of the United States of America
October 16, 2012 vol. 109 no. 42, Misconduct accounts for the majority of retracted scientific publications, By: Fang et al“A detailed review of all 2,047 biomedical and life-science research articles indexed by PubMed as retracted on May 3, 2012 revealed…67.4% of retractions were attributable to misconduct, including fraud or suspected fraud (43.4%), duplicate publication (14.2%), and plagiarism (9.8%). Incomplete, uninformative or misleading retraction announcements have led to a previous underestimation of the role of fraud in the ongoing retraction epidemic.”Documentation

“The percentage of scientific articles retracted because of fraud has increased ∼10-fold since 1975.”

The Washington Post, March 11, 2013- “You have a lot of people who want to do the right thing, but they get in a position where their job is on the line or their funding will get cut, and they need to get a paper published, then they have this tempting thought: If only the data points would line up… ” Dr. Ferric C. Fang, M.D., medical professor at the University of Washington.Documentation

Drug advertisements are also getting just as phony as most industry funded published studies.

United States Congress. Advertising, marketing and promotional practices of the pharmaceutical industry: Hearing before the committee on labor and human resources. 101st Congress, 2nd Session. Washington, DC: U.S. Government Printing Office; 1991.
Testimony of Dr. Nicole Lurie, M.D., M.S.P.H., Professor in the University of Minnesota School of Medicine.
p-142 “Avorn and colleagues found that the majority of physicians held “advertising oriented beliefs” but that they were unaware that they were “strongly influenced” by non scientific sources. In other words, these physicians believed things about certain drugs that were not scientifically correct and that they could only have heard from pharmaceutical advertising sources.”Documentation

United States Congress. Advertising, marketing and promotional practices of the pharmaceutical industry: Hearing before the committee on labor and human resources. 101st Congress, 2nd Session. Washington, DC: U.S. Government Printing Office; 1991.
Testimony of David C. Jones, Fmr. VP of Abbott Laboratories
p-19-20 “Consumer demand is created through the news media. Print and broadcast outlets are flooded with packaged stories ready to print and TV productions ready to air. They target doctors, consumers or both…The price of prescription drugs is determined by what the market will bear. Pain, suffering and desperation will support a high price, indeed…”
P-23 “Drug companies have institutionalized deception.”
p-35 “Doctors must find the integrity to resist the temptations laid before them by drug companies.”Documentation

“Only 6% of drug advertising material is supported by evidence”

British Medical Journal, 2004 Feb 28;328(7438):485.
Only 6% of drug advertising material is supported by evidence. By: Annette Tuffs
“A new study of the advertising material and marketing brochures sent out by drug companies to GPs in Germany has shown that about 94% of the information in them has no basis in scientific evidence.”Documentation

Netherlands Journal of Medicine, 2010 Jan;68(1):46-9.
Are claims of advertisements in medical journals supported by RCTs? (Randomized Controlled Trials)
By: Heimans, van Hylckama Vlieg & Dekker.CONCLUSION: “RCTs used to support claims in medical advertisements are often not a high-quality and independent source of evidence. This distracts from the credibility of claims in advertisements, even in the high-ranked journals.”
Overall, only 39.2% of the advertisements used in this study referenced a high-quality trial which supported their claim.Documentation

Journal of General Internal Medicine, 2013; 29(1):110 – 118
Content Analysis of False and Misleading Claims in Television Advertising for Prescription and Nonprescription Drugs. By:Adrienne E. Faerber, Ph.D., and David H. Kreling, Ph.D.“False or potentially misleading claims appeared in 66% of televised drug advertisements…Since false claims are illegal, this study should have found no false claims.”Documentation Scientific American– “Study Finds Most Drug Commercials Misleading”

Mens Sana Monographs, 2010 Jan;8(1):129-45
Of sophists and spin-doctors: industry-sponsored ghostwriting and the crisis of academic medicine.
By: Dr. Leemon McHenry, Ph.D.“In our age, the rise of pharmaceutical marketing is a new form of *sophistry that undermines the integrity of the research published in the peer-reviewed medical journals and the reputation of the medical profession. The serious attempt to discover efficacy or safety in medicine is irrelevant to the goal of promotion.”*sophistry- reasoning with clever yet false and deceptive arguments.Documentation

Health Economics, Policy and Law, 2012,Volume 7; Issue 02: pp 175 ­ 195
Pharmaceutical lobbying under postcommunism: universal or country­specific methods of securing state drug reimbursement in Poland? By: Ozierański et al. “Publications favourable for drug companies may also result from the fact that ‘‘For the majority of journalists, medicine is just one of many topics.’’ Therefore, cooperation with journalists sometimes takes the form of ghost-writing: ‘‘Briefing journalists typically comes down to providing them with already prepared texts. Firms [Pharmaceutical companies] prefer to give them materials on a pen drive or a CD, so that the journalist can just do the ‘copy-paste.’ ’’
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Pseudo-Evidence Based Medicine: When Biomedical Research Becomes an Adjunct of Pharmaceutical Marketing. In Free Knowledge¸ editors: Patricia W. Elliott and Daryl Hepting, University of Regina Press, 2015, pp. 26-42
By: Professor Arthur Schafer, University of Manitoba“When university students put their names to work that they have not done themselves, they are failed for plagiarism. Surprisingly, a significant number of university scientists seem comfortable accepting drug company money in exchange for putting their names to studies that have been designed and carried out by company employees.”Documentation

New York Times, May 2, 2006, The Doctor’s World
For Science’s Gatekeepers, a Credibility Gap, By: Lawrence K. Altman, M.D.“Journals seldom investigate frauds that they have published, contending that they are not investigative bodies and that they could not afford the costs. Instead, the journals say that the investigations are up to the accused authors’ employers and agencies that financed the research.”Documentation

The prevalence of fake scientific studies has led to a new industry that attempts to detect them.

SciDetect Software was launched for Evaluating Academic Papers by Université Joseph Fourier in collaboration with the Springer publishing house. It is a computer program that spots phony research papers. Last year Springer had to pull 18 fake papers, while another publisher, IEEE, had to pull more than 100.)

Many medical journals have no policies regarding conflicts of interest in published research studies

Cancer, 1 January 2012, Volume 118, Issue 1, pages 188–195.
Conflict of interest in oncology publications, A survey of disclosure policies and statements
By: Kesselheim et al. Harvard Medical School.
Scores of studies have shown that when researchers have a financial stake in their work, their reports are more likely to promote drugs and downplay side effects.

“Physicians — like other professionals — are influenced by incentives, especially financial incentives,”said Kesselheim. “Conflicts of interest and financial relationships can have an impact on the research process and on the reporting of research, and they can also have an impact on physician behavior.”

The researchers found that of 131 cancer journals, only 112 had policies requiring researchers to state conflicts of interest, such as drugmaker stock ownership or speaker fees. And among journals that did have such policies, the rules were all over the map. “Journals can’t even agree on what a conflict of interest means,” said Dr. Aaron S. Kesselheim of the Harvard Medical School in Boston.DocumentationReuters-Transparency rules a tangle at cancer journals

Conflicts of Interest in Clinical Trials
Presented by Vera Hassner Sharav 14th Tri-Service Clinical Investigation SymposiumSponsored by The U.S. Army Medical Department
and The Henry M. Jackson Foundation for the Advancment of Military Medicine May 5-7, 2002“Financial conflicts of interest of clinical investigators… [is] the single issue that [ ] poses the greatest threat to maintaining public trust in biomedical research.”Documentation

“…compensation with stock for clinical research is a “widespread industry practice.”

Seton Hall University School of Law, (November 2009)
Conflicts of Interest in Clinical Trial Recruitment & Enrollment: A Call for Increased Oversight
Center for Health & Pharmaceutical Law & Policy. By: Boozang et al.“Some trial sponsors remunerate investigators with company stock or stock options. According to New Jersey’s Attorney General, compensation with stock for clinical research is a “widespread industry practice.” Compensation with equity in the sponsor creates a conflict of interest for physician-investigators because it gives them a stake in the outcome of the research. If the data from the trial are positive, it will boost the sponsor’s bottom line, which will in turn increase the investigator’s gain through increased stock value and the potential for higher dividend payments.”Documentation

Pseudo-Evidence Based Medicine: When Biomedical Research Becomes an Adjunct of Pharmaceutical Marketing. In Free Knowledge¸ editors: Patricia W. Elliott and Daryl Hepting, University of Regina Press, 2015, pp. 26-42. By: Professor Arthur Schafer, University of Manitoba“…if a researcher stands to gain monetary and/or career success by demonstrating the safety and efficacy of a sponsor’s new drug, but stands to lose research funding and perhaps her job if she finds that the new drug is unsafe or ineffective, then she is in a conflict of interest situation.”Documentation

Journal of the American Medical Association, 2008;300(9): pages 1069-1071
Industry-Sponsored Clinical Research A Broken System
By: Dr. Marcia Angell, M.D., Harvard Medical School, former editor-in-chief of the New England Journal of Medicine.“In addition to grant support, faculty investigators often have other financial ties to the sponsors of their research. They serve as paid consultants and members of speakers’ bureaus and advisory boards and sometimes even have equity interest in the companies. Such conflicts of interest would once have been prohibited by academic medical centers, but those institutions now have their own extensive financial ties to industry and are hardly in a moral position to object to their faculty behaving in the same way. A recent review found that about two-thirds of academic medical centers hold equity interest in companies that sponsor research within the same institution, and a study of medical school department chairs found that two-thirds received departmental income from drug companies and three-fifths received personal income.”Documentation

British Medical Journal, 2015;350:h2942
Justifying conflicts of interest in medical journals: a very bad idea
By:Robert Steinbrook professor adjunct of internal medicine, Jerome P Kassirer distinguished professor, Marcia Angell senior lecturer on social medicine.“Physicians and the public rely on journals as unbiased and independent sources of information and to provide leadership to improve trust in medicine and the medical literature. Yet financial conflicts of interest have repeatedly eroded the credibility of both the medical profession and journals…Judges are expected to recuse themselves from hearing a case in which there are concerns that they could benefit financially from the outcome. Journalists are expected not to write stories on topics in which they have a financial conflict of interest. The problem, obviously, is that their objectivity might be compromised, either consciously or unconsciously, and there would be no easy way to know whether it had been. Yet Rosenbaum and Drazen seem to think it is insulting to physicians and medical researchers to suggest that their judgment can be affected in the same way. Doctors might wish it were otherwise, but none of us is immune to human nature.”Documentation

“Pharmaceutical companies offered gifts or payments on at least one occasion in the past year to 82 percent of physicians…”

United States Department of Health and Human Services, Office of the Inspector General
Promotion of Prescription Drugs Through Payments and Gifts.(OEI-01-90-00480) (1991)
“Pharmaceutical companies offered gifts or payments on at least one occasion in the past year to 82 percent of physicians and on 5 or more occasions to 79 percent…Pharmaceutical companies were more likely to offer gifts and payments to physicians who were frequent prescribers than to those who were infrequent prescribers… Pharmaceutical companies offered gifts or payments explicitly defined by the current guidelines as being inappropriate on at least one occasion to 27 percent of physicians.”Documentation

The Pew Charitable Trusts, September 2014, What is your Doctor getting paid?Documentation

United States Department of Veterans Affairs
A Report by the National Ethics Committee of the Veterans Health Administration (2003)
Gifts to Health Care Professionals from the Pharmaceutical Industry“Some 80% of physicians report having been offered cash or gifts from pharmaceutical industry representatives…[a] significant number of patients believe that industry gifts bias their physician’s prescribing practices and ultimately drive up medical costs…In the context of a gift to a health care professional from a pharmaceutical industry representative, practitioners commonly understand that the hoped for reciprocation involves the health care professional writing more prescriptions for the drug(s) the representative is promoting.”Documentation

“All expense paid” trips influence Doctor prescribing patterns

United States Congress. Advertising, marketing and promotional practices of the pharmaceutical industry: Hearing before the committee on labor and human resources. 101st Congress, 2nd Session. Washington, DC: U.S. Government Printing Office; 1991.
Senator Edward M. Kennedy on P 2-3 “Pharmaceutical companies are spending larger and larger sums on questionable tactics that subvert basic medical standards, tempting doctors with lavish vacations, gifts and cash payments…Patients have the right to expect that a prescription drug they are taking is medically appropriate for their illness, not part of their doctor’s ‘frequest prescriber vacation plan.'”p-153 “We invited Abbott, CIBA-GEIGY, Wyeth-Ayerst and Hoffman-LaRoche to appear at today’s hearing to respond to these allegations, but all four companies declined to appear.” p-154 “…why did Abbott sponsor an all-expenses-paid symposium at Disneyworld for doctors and spouses, devoted entirely to unapproved uses of Lupron?”Documentation

Chest, 1992; 102; 270-273
The effects of pharmaceutical firm enticements on physician prescribing patterns. There’s no such thing as a free lunch. By: Orlowski & Wateska“The physicians in this study did not feel that the largesse of an expense-paid trip to a resort to attend a seminar concerning a drug would influence their prescribing of that drug. Nevertheless, a significant and substantial increase in the prescribing of that drug occurred subsequent to the inducement…Such efforts clearly influence behavior, despite our feelings to the contrary.”Documentation

Canadian Medical Association Journal, 1993 Nov 15; 149(10): 1401–1407
Interactions between physicians and the pharmaceutical industry: what does the literature say?
By: Dr. Joel Lexchin, M.D.“Of 20 physicians interviewed before they went to conferences none felt that their prescribing behaviour would be affected…[Their acceptance of the “all-expenses-paid” trip]…demonstrated a significant increase in prescribing the drugs that had been the subjects of the symposia…some 77% of physicians favoured the commercial view of a product rather than the scientific view…Conclusions: Physicians are affected by their interactions with the pharmaceutical industry.”Documentation

Journal of Medical Education, 1980; 55:453-455
Teaching drug promotion abuses to health profession students.
By: Palmisano & Edelstein
This study found that 85% of medical students believe it is improper for politicians to accept a gift, whereas only 46% found it improper for themselves to accept a gift of similar value from a pharmaceutical company.Documentation

Journal of the American Medical Association, 2000, Vol. 283, No. 3: pages 373-380
Physicians and the Pharmaceutical Industry: Is a Gift Ever Just a Gift?
By: Dr. Ashley Wazana, M.D.“Conclusion The present extent of physician-industry interactions appears to affect prescribing and professional behavior and should be further addressed at the level of policy and education.”Documentation

United States Congress. Advertising, marketing and promotional practices of the pharmaceutical industry: Hearing before the committee on labor and human resources. 101st Congress, 2nd Session. Washington, DC: U.S. Government Printing Office; 1991.
Testimony of Dr. Sidney M. Wolfe, M.D., Director, Public Citizen Health Research Group.
p-49 “If a judge sitting on an important case were bribed by one or two of the parties involved in the case in order to influence his or her decision, we would all be outraged, and the judge, if discovered, would be criminally prosecuted. To the extent that physicians are in a real sense judges of what is wrong with patients and what tests or treatments to prescribe, doctors’ decision making must be shielded from influences other other than what is in the best interest of the patient.”

p-50 [Regarding Wyeth-Ayerst frequent prescriber/free flying doctor program] “They worked out a deal with American Airlines wherein any time a doctor who participated in their frequent flier program prescribed this drug, he would get 1,000 frequent flier bonus miles on American Airlines. Fifty prescriptions of 50 “tricks,” so to speak for the company, and a doctor would get a free coach ticket on American Airlines anywhere in the United States…American Airlines said they would not tell how many doctors participated, but that it was “a very successful program from our standpoint.”

p-52 “The drug companies and the doctors whom they bribe are classic examples of white-coated and white-collared crime.”

p-80 “We have the majority of American drug companies involved in what I think is clearly criminal activity in some way or other to try and influence doctors ro prescribe their drug.”Documentation

“Doctors fear drug companies like bookies fear the mob…”

The Israel Medical Assocation Journal, 2011 Jul;13(7):389-93.
The physician’s relationship with the pharmaceutical industry: caveat emptor…buyer beware!
By: Albersheim & Golan“When money is given or a favor promised in order to influence judgment or conduct of a person in a position of trust, this is a bribe.”Documentation

The Lancet, 2005 Jul 30-Aug 5;366(9483):422-4.
Should journals publish industry-funded bioethics articles?
By: Dr. Carl Elliott, M.D., Ph.D.“Even discussions of conflict of interest have become tainted by questions of conflict of interest—or at least the perception of a potential conflict. The American Journal of Bioethics recently published an article on the ethics of taking gifts from the pharmaceutical industry which was itself funded by Pfizer…Newspapers have understood this for years. Financial columnists are not allowed to accept money from the companies they write about, and film critics are not allowed to accept money from the studios producing the films they review.”Documentation

Referees are not permitted to accept benefits or gifts from team owners.
Police are not allowed to accept benefits or gifts from crime suspects.
Judges are not permitted to accept benefits or gifts from litigants.
Professors are not allowed to accept benefits or gifts from students.
Journalists are not allowed to accept benefits or gifts from their subjects.
Film critics are not allowed to accept money from the studios producing the films they review.
This is because referees, police officers, judges, professors, and journalists are obligated to exercise their judgment impartially according to professional standards.Why are Doctors any different?

Annals of Family Medicine, 2005, Jan; 3(1): 82–85
The Company We Keep: Why Physicians Should Refuse to See Pharmaceutical Representatives
By: Dr. Howard Brody, M.D., Ph.D.“The goal of the pharmaceutical industry is to increase its profits, which includes persuading physicians to prescribe more of the most expensive drugs…systematic reviews of the literature confirmed a direct relationship between the frequency of contact with reps and the likelihood that physicians will behave in ways favorable to the pharmaceutical industry.5,6Physicians who spend more time with reps are less likely to prescribe rationally.”7Documentation5. Wazana A. Physicians and the pharmaceutical industry: is a gift ever just a gift? JAMA. 2000;283:373–380. [PubMed]
6. Reviews: What impact does pharmaceutical promotion have on behavior? Drug Promotion Database. Available at: http://www.drugpromo.info/read-reviews.asp?id=4. Accessed 29 April 2004.
7. Figueiras A, Caamano F, Gestal-Otero JJ. Influence of physician’s education, drug information and medical-care settings on the quality of drugs prescribed. Eur J Clin Pharmacol. 2000;56:747–753. [PubMed]

The American Journal of Bioethics, 2003, Volume 3, Number 3
Large or Small, a Gift Is a Gift Is a Gift. By: Dr. John J. Paris, S.J., Ph.D.
“The purchase of physicians’ behavior with the dispensing of gifts is not *de minimis [*too trivial or minor to merit consideration, especially in law]. Nor ought the behavior continue to be thought of us such.Documentation

Family Practice, 2009; 26: 169–170.
Pharmaceutical representatives do influence physician behaviour. By: Dr. Gwyn Harris, M.D. “It is a not a truth universally acknowledged that pharmaceutical representatives influence physician behaviour. However, the pharmaceutical industry clearly believes they do…This study adds to our knowledge of the subject and reminds us that there is no such thing as a free lunch; these visits really do result in increased sales.”Documentation

Food and Drug Law Journal, 2010, Vol. 65, No.1; pages 141-157
Mirror, Mirror on the Wall—Evaluating Fair Market Value for Manufacturer-Physician Consulting Arrangements. By: Fred Eaton and Jaimee Reid These cases show the abusive practices that Medical companies engage in that are often disguised as consulting contracts, royalty agreements, or gifts.Documentation

1. The DOJ [Department of Justice] alleged that Medtronic made kickbacks such as inequitable consulting and royalty agreements; trips for doctors, their spouses and families; meetings at lavish venues and company-sponsored adult entertainment… Medtronic denied any wrongdoing but was accused of paying kickbacks to physicians to induce physicians to select Medtronic’s products… As part of this settlement, Medtronic paid $40 million as part of the settlement and signed a five-year CIA.[Corporate Integrity Agreement]Documentation

2. The U.S. Attorney’s Office for the District of New Jersey conducted an industrywide investigation of orthopedic companies and physician consultants. As a result, the U.S. Attorney’s Office entered to parallel settlements with five companies that made up for nearly 95 percent of the market in hip and knee surgical implants. All five major medical device manufactures settled with the government over federal fraud and abuse claims…The suits alleged that the companies had inappropriately paid physician consultants millions of dollars. As a part of the settlement, the companies agreed to pay $311 million to settle the Anti-Kickback Statute and the False Claims Act allegations.Documentation

U.S. Attorney Christopher J. Christie“This industry routinely violated the anti-kickback statute by paying physicians for the purpose of exclusively using their products…we expect doctors to make decisions based on what is in the best interests of their patients – not the best interests of their bank accounts.”

Gary Heuer, Special Agent in Charge of the HHS-OIG in New York“Patients in federal health care programs deserve the best available treatment from physicians and surgeons without the corrupting influence of kickbacks…”

Journal and Proceedings of the Northern Ireland Ethics Forum, 2008; 5, pages 42-49.
Ethical concerns regarding misleading drug promotion/marketing by the pharmaceutical industry
By: Ayomide Esan & Petr Mansfield“The selective use of information presented to physicians reduces their ability to make weighted decisions based on all the available evidence, resulting in sub optimal usage of potentially useful drugs…and is most often due to confirmation bias resulting from the conflict of interest involved in evaluatory studies on drugs, sponsored by the pharmaceutical companies which produce them…For the time being, the onus remains on healthcare professionals to ensure that when educating themselves on pharmaceutical products, they only make use of objective sources, among which promotional materials from the pharmaceutical industry cannot in good conscience be counted.”Documentation

Health Economics, Policy and Law, 2012, Volume 7; Issue 02: pp 175-195
Pharmaceutical lobbying under postcommunism: universal or country specific methods of securing state drug reimbursement in Poland? By: Ozierański et al.“…Sometimes, when I listen to acknowledged professors singing praises of a medicine during a meeting organised by the firm, I keep saying to myself: ‘Gosh, I would never sell myself like this for any money.’ ’’

The Guardian, September 23, 2011, “Cambridge University report finds pharmaceutical firms pay doctors to use their products”Documentation

PLoS Medicine, 2011, 8(4): e1000431.
Strategies and Practices in Off-Label Marketing of Pharmaceuticals: A Retrospective Analysis of Whistleblower Complaints. By: Kesselheim et al.
This study stated that Pharmaceutical manufacturers encouraged: “off-label use through direct financial incentives to physicians… Lavish gifts or honoraria were mentioned in most complaints (35/41, 85%), with many whistleblowers reporting strategies to target these gifts to physicians who were high off-label prescribers (18/41, 44%). In some cases, physicians might be invited to serve in focus groups or as consultants to the manufacturer…not to obtain expert advice, but to provide money to prescribers to positively reinforce off-label use.”Documentation

The New York Times- Dr. Drug Rep, November 25, 2007, By. Dr. Daniel Carlat, M.D. “…one recent study indicates that at least 25 percent of all doctors in the United States receive drug money for lecturing to physicians or for helping to market drugs in other ways.”Documentation